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Cummings Otolaryngology
Head and Neck Surgery, 3-Volume Set
- 7th Edition - May 11, 2020
- Authors: Paul W. Flint, Bruce H. Haughey, Valerie J. Lund, K. Thomas Robbins, J. Regan Thomas, Marci M. Lesperance, Howard W. Francis
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 6 1 2 1 6 - 6
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 6 1 1 7 9 - 4
The most comprehensive, multi-disciplinary text in the field, Cummings Otolaryngology: Head and Neck Surgery, 7th Edition, provides detailed, practical answers and easily acces… Read more
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Request a sales quoteThe most comprehensive, multi-disciplinary text in the field, Cummings Otolaryngology: Head and Neck Surgery, 7th Edition, provides detailed, practical answers and easily accessible clinical content on the complex issues that arise for otolaryngologists at all levels, across all subspecialties. This award-winning text is a one-stop reference for all stages of your career—from residency and board certification through the challenges faced in daily clinical practice. Updated content, new otology editor Dr. Howard W. Francis, and new chapters and videos ensure that this 7th Edition remains the definitive reference in today’s otolaryngology.
- Brings you up to date with the latest minimally invasive procedures, recent changes in rhinology, and new techniques and technologies that are shaping patient outcomes.
- Contains 12 new chapters, including Chronic Rhinosinusitis, Facial Pain, Geriatric Otology, Middle Ear Endoscopic Surgery, Pediatric Speech Disorders, Pediatric Cochlear Implantation, Tongue-Ties and Lip Ties, Laryngotracheal Clefts, and more.
- Covers recent advances and new approaches such as the Draf III procedure for CRS affecting the frontal recess, endoscopic vidian and posterior nasal neurectomy for non-allergic rhinitis, and endoscopic approaches for sinonasal and orbital tumors, both extra- and intraconal.
- Provides access to 70 key indicator (Accreditation Council for Graduate Medical Education Key Indicator Procedures), and surgical videos – an increase of 43% over the previous edition.
- Offers outstanding visual support with 4,000 high-quality images and hundreds of quick-reference tables and boxes.
- Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Otolaryngologists– trainee and practicing
- Cover image
- Title Page
- Table of Contents
- Copyright
- Contributors
- Preface
- Acknowledgments
- Video Contents
- Volume I
- Part I Measuring Outcomes and Performance
- 1 Outcomes Research
- Introduction
- History
- Key Terms and Concepts
- Fundamentals of Study Design
- Measurement of Clinical Outcomes
- Summary and Future Directions
- References
- 2 Interpreting Medical Data
- Seven Habits of Highly Effective Data Users
- Popular Statistical Tests Used by Otolaryngologists
- Common Statistical Deceptions
- Understanding Sample Size
- Importance of Principles
- References
- 3 Evidence-Based Performance Measurement
- Motivation for Physician Performance Measurement
- What Is Quality and Who Defines It?
- The Process of Building a Coherent System of Performance Measurement
- Medical Professionalism: the Physician-Patient Relationship
- Other Stakeholder Perspectives
- Barriers to Implementation of Performance Measurement
- References
- Part II General Otolaryngology
- 4 History, Physical Examination, and the Preoperative Evaluation
- Obtaining the History
- Physical Examination
- Special Populations
- Preoperative Evaluation
- Considerations by Organ System
- Conclusion
- References
- 5 General Considerations of Anesthesia and Management of the Difficult Airway
- Basic Anesthetic Care of the Patient With a NonDifficult Airway
- Standard Anesthetic Pharmacology
- Difficult Airway/Intubation: a Multispecialty Problem
- Difficult Airway/Intubation
- Johns Hopkins Hospital Difficult Airway Response Team Program and a Decade of Lessons Learned (2008–18)
- Documentation and Dissemination of Critical Difficult Airway/Intubation Information to Patients and Future Health Care Providers
- Conclusion
- Case-Based Learning: Case Presentations of Difficult Airway/Intubation Patients
- Case-Based Learning Summary
- Acknowledgment
- References
- 6 Surgical Management of the Difficult Adult Airway
- Overview
- Awake Fiberoptic Intubation
- Operative Surgical Airway
- Cricothyrotomy
- Transtracheal Needle Ventilation
- Conclusion
- References
- 7 Tracheotomy
- History of Tracheotomy
- Timing of Tracheotomy
- Operative Technique
- Complications
- Tracheostomy Care
- Decannulation
- References
- 8 Overview of Diagnostic Imaging of the Head and Neck
- Available Imaging Modalities
- Applications of Computed Tomography, Magnetic Resonance Imaging, and Ultrasound in the Head and Neck
- Principles of Image Interpretation
- Imaging Anatomy, Site-Specific Lesions, and Pseudotumors of the Head and Neck
- Sinuses and Skull Base
- Postoperative Neck and Face
- References
- 9 Deep Neck and Odontogenic Infections
- Etiology
- Microbiology
- Anatomy
- Clinical Evaluation
- Laboratory Evaluation
- Treatment
- Selected Complications of Deep Neck Infections
- References
- 10 Head and Neck Manifestations in the Immunocompromised Host
- Spectrum of Immunodeficiency
- Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
- Immunodeficiency and Malignancy
- Salivary Gland Disease
- Diagnostic Approach to Neck Masses in Immunodeficient Patients
- Sinonasal Infection
- Otologic and Neurologic Manifestations of Immunodeficiency
- Oral Cavity
- HIV-Associated Facial Lipoatrophy
- Summary
- References
- 11 Laryngeal and Tracheal Manifestations of Systemic Disease
- Granulomatosis With Polyangiitis
- Relapsing Polychondritis
- Sarcoidosis
- Amyloidosis
- Rheumatoid Arthritis
- Pemphigus
- Whooping Cough
- Tuberculosis
- Histoplasmosis
- Blastomycosis
- Cryptococcosis
- Coccidioidomycosis
- Candidiasis
- References
- 12 Oral Manifestations of Systemic Diseases
- Diseases of the Heart
- Malignant Neoplasms
- Bisphosphonates
- Cerebrovascular Diseases
- Pulmonary Diseases
- Endocrine and Exocrine Disorders
- Collagen-Vascular and Granulomatous Disorders
- Infectious Diseases
- Arthritides and Bone Disorders
- Dermatologic Conditions
- Gastrointestinal Disorders
- Neurologic Diseases
- Diseases of Organs and Glands
- Hematologic Disorders
- Women's Oral Health and Disease
- Inherited and Congenital Disorders
- References
- 13 Otolaryngology in the Elderly
- The Aging Ear
- Presbystasis
- The Aging Nose
- The Aging Voice and Upper Aerodigestive Tract
- Presbyphagia
- Facial Trauma
- Head and Neck Oncology
- Conclusion
- References
- 14 Pain Management in the Head and Neck Patient
- Measurement of Pain
- Acute Pain Management
- Cancer and Chronic Noncancer Pain
- References
- 15 Sleep Apnea and Sleep Disorders
- Historic Perspectives
- Classification of Obstructive Sleep-Related Breathing Disorders
- Pathophysiology
- Consequences of Untreated Obstructive Sleep Apnea
- Diagnosis
- Treatment
- Postoperative Management
- Sleep Disorders
- Conclusion
- References
- Part III Facial Plastic and Reconstructive Surgery
- Section 1 Facial Surgery
- 16 Aesthetic Facial Analysis
- Anatomic Landmarks and Reference Points
- Facial Proportions
- Subunit Analysis
- Computer Imaging and Digital Photography
- References
- 17 Recognition and Treatment of Skin Lesions
- Introduction
- Benign Skin Lesions
- Malignant Skin Lesions
- References
- 18 Scar Revision, Keloids, and Camouflage
- Indications for Revision
- Excision
- Hypertrophic Scars and Keloids
- Conclusion
- References
- 19 Facial Trauma
- Etiology
- Approach to Traumatic Injuries
- Types of Injuries
- Special Considerations in Repair of Specific Structures
- Burns
- Special Considerations
- Conclusion
- References
- 20 Maxillofacial Trauma
- Anatomy, Physiology, and Pathophysiology
- Evaluation and Diagnosis
- Classification Schema
- Management
- Bone Healing
- Biomechanics of the Facial Skeleton
- Fracture Repair
- Cerebrospinal Fluid Rhinorrhea
- Complications
- Future Directions and New Horizons
- References
- 21 Reconstruction of Facial Defects
- Classification of Local Flaps
- Defects of the Nose
- Defects of the Lip
- Reconstruction of Cheek Defects
- Forehead Defects
- References
- 22 Hair Restoration
- Pathophysiology
- Etiology
- Classification
- Medical Treatment of Androgenetic Alopecia
- Candidacy
- Surgical Treatment of Alopecia
- Hairline Design
- Anesthesia
- Autograft Hair Transplantation
- Scalp Reduction
- Tissue Expansion
- Temporoparietal-Occipital Flap
- Reconstructive Procedures
- Future Treatment Options
- Summary
- References
- 23 Management of Aging Skin
- Chemical Peels
- Dermabrasion
- Laser Resurfacing
- Summary
- References
- 24 Rhytidectomy and Facial Liposuction
- Historic Perspective
- Anatomic Considerations
- Surgical Technique
- References
- 25 The Aesthetic Brow and Forehead
- Ideal Forehead Aesthetics
- Anatomy
- Aging Brow and Forehead
- Endoscopic Brow Lift Technique
- Postoperative Care
- Conclusion
- References
- 26 Blepharoplasty
- Anatomy
- Aesthetic Considerations and Ideals in the Periorbital Area
- Preoperative Planning
- Surgical Techniques
- Adjunctive Procedures
- References
- 27 Mentoplasty
- Patient Evaluation
- Chin Deformities
- Procedure Selection
- Surgical Technique
- Complications
- Clinical Example
- Summary
- References
- 28 Otoplasty
- History
- Incidence
- Etiology
- Embryology, Anatomy, and Pathophysiology
- Goals and Fundamentals of Otoplasty
- Complications
- Summary
- References
- Section 2 Rhinoplasty
- 29 The Nasal Septum
- Anatomy and Embryology of the Nose
- Nasal Obstruction
- Nasal Physiology: Resistance and Airflow
- Septoplasty Technique and Evolution
- Septoplasty Today
- Conclusion
- References
- 30 Nasal Fractures
- Anatomy
- Pathophysiology
- Classification
- Diagnostic Assessment
- Management
- Technique
- Pediatric Nasal Fractures
- Complications
- References
- 31 Rhinoplasty
- Surgical Philosophy
- Preoperative Patient Assessment
- Surgical Refinement of the Nasal Tip
- Surgery of the Cartilaginous Vault
- Surgery of the Bony Vault
- Postsurgical Considerations
- 32 Special Rhinoplasty Techniques
- Analysis
- Septal and Columellar Modifications
- Columellar Alar Relationship
- Nasofrontal Angle Modifications
- Tip and Alar Asymmetries
- Saddle Nose Deformity
- Non-Caucasian Nose
- Cleft-Lip Nose
- Summary
- References
- 33 Non-Caucasian Rhinoplasty
- Anatomic Considerations
- Aesthetic Considerations
- Augmentation Rhinoplasty
- Hump Reduction
- Correction of a Deviated Nose
- Tip Surgery
- Alar Base Modification
- Postoperative Care
- Complications
- Conclusion
- References
- 34 Revision Rhinoplasty
- Introduction
- Patient Interview
- Physical Examination
- Surgical Approach
- Grafting Material
- Targeted Approach to Revision Rhinoplasty
- References
- Part IV Sinus, Rhinology, and Allergy/Immunology
- 35 Allergy and Immunology of the Upper Airway
- Innate Versus Adaptive Immunity
- Components of the Innate Immune System
- Adaptive Immunity: Cells of the Immune System and Their Responses
- Adaptive Immunity: Humoral Immune Response
- Immunopathology
- Allergic Rhinitis
- Pathophysiology of Allergic Rhinitis
- Evaluation and Diagnosis
- Therapeutic Options
- Combination Treatments
- Intralymphatic Immunotherapy
- References
- 36 Olfactory Function and Dysfunction
- Anatomy
- Physiology
- Olfactory Dysfunction
- Impact of Olfactory Dysfunction
- Classification of Olfactory Dysfunction
- Common Causes of Olfactory Dysfunction
- Clinical Assessment
- Treatment
- Conclusions
- Acknowledgments
- References
- 37 Objective Assessment of Nasal Function
- Objective Assessment of Nasal Function
- Mucociliary Transport and Function
- Objective Assessment of Nasal Airway
- Conclusions
- References
- 38 Imaging of Nose and Sinuses
- Imaging Techniques
- Anatomy
- Pathology
- Neoplasms
- References
- 39 Nonallergic Rhinitis
- Introduction
- Pathophysiology
- Types of Nonallergic Rhinitis (Box 39.1)
- History and Physical Examination
- Diagnostic Testing
- Medical Treatment of Nonallergic Rhinitis
- Surgical Treatment of Nonallergic Rhinitis
- References
- 40 Acute Rhinosinusitis
- Definitions of Acute and Chronic Rhinosinusitis
- Acute Rhinosinusitis
- Summary
- References
- 41 Pathogenesis of Chronic Rhinosinusitis
- Introduction
- Environmental Factors
- Host Factors
- Platelets
- Theories of Etiology and Pathogenesis
- References
- 42 Chronic Rhinosinusitis
- Introduction
- Medical Therapies
- Conclusion
- References
- 43 Chronic Rhinosinusitis
- Outcomes Research for Chronic Rhinosinusitis
- Outcomes Following Medical Treatment
- Outcomes Following Endoscopic Sinus Surgery
- Future Outcomes Research in Chronic Rhinosinusitis
- References
- 44 Primary Sinus Surgery
- Background
- Anatomy
- Indications for Primary Sinus Surgery
- Endoscopic Sinus Surgery for Rhinosinusitis
- External Procedures
- Conclusions
- Acknowledgments
- References
- 45 Causes of Failure, Revision Surgery for Rhinosinusitis, and Management of Complications in Endoscopic Sinus Surgery
- Introduction
- Causes of Failure
- Medical Factors Associated With Primary Surgical Failure
- Iatrogenic Factors Associated With Primary Surgical Failure
- Early Revision Surgery for Complications or Neoplasia
- Clinical Approach to the Revision Surgical Patient
- Conclusion
- References
- 46 Management of the Frontal Sinuses
- Surgical Anatomy of the Frontal Sinus
- Acute Frontal Sinusitis
- Chronic Frontal Sinus Disease
- Specific Pathologic Conditions
- External Approaches to the Frontal Sinus
- References
- 47 Epistaxis
- Anatomy
- Management
- Pediatric Epistaxis
- Summary
- References
- 48 Cerebrospinal Fluid Rhinorrhea
- Introduction
- Historical Perspective
- Classification
- Pathophysiology
- Diagnosis
- Management
- Conclusions
- References
- 49 Sino-Orbital Interface
- Endoscopic Dacryocystorhinostomy
- Anatomy
- Diagnostics
- Procedure
- Outcomes
- Complications
- Conclusions
- Endoscopic Medial and Inferior Orbital Decompression
- Endoscopic Optic Nerve Decompression
- Endoscopic Endonasal Management of Orbital Tumors
- Conclusion
- References
- 50 Benign Tumors of the Sinonasal Tract
- Sinonasal Papillomas
- Juvenile Angiofibroma
- Osteoma
- Lobular Capillary Hemangioma
- Ossifying Fibroma and Fibrous Dysplasia
- Schwannoma
- Acknowledgment
- References
- 51 Systemic Disease of the Nose and Sinuses
- Background
- Granulomatosis With Polyangiitis (Formerly Wegener Granulomatosis)
- Sarcoidosis
- Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss Syndrome)
- Cocaine-Induced Midline Destructive Lesion
- Relapsing Polychondritis
- Extranodal NK/T-Cell Lymphoma
- Cholesterol Granuloma
- Mycobacteria
- Rhinoscleroma
- Actinomycosis
- Rhinosporidiosis
- Syphilis
- Blastomycosis
- Histoplasmosis
- References
- 52 Facial Pain
- Introduction
- Workup
- Differential Diagnosis
- Summary
- References
- Part V Laryngology and Bronchoesophagology
- 53 Laryngeal and Pharyngeal Function
- Laryngeal Motion
- Laryngeal Function in Breathing
- Pharyngeal Function in Breathing
- Function in Speech
- References
- 54 Visual Documentation of the Larynx
- Videoendoscopy and Stroboscopy
- Stroboscopy Systems
- Laryngeal High-Speed Videoendoscopy
- Narrow-Band Imaging
- Emerging Technologies
- References
- 55 Voice Evaluation and Therapy
- Patient-Reported Outcome Instruments
- Perceptual Assessment
- Instrumental Assessment
- Diagnostic Therapy
- Introduction to Therapy for Voice and Laryngeal Airway Disorders
- Conclusions
- References
- 56 Neurologic Evaluation of the Larynx and Pharynx
- Normal Function
- Neurologic Examination of the Mouth, Larynx, and Pharynx
- Ancillary Tests
- Performance Measures and Investigations
- Other
- Summary
- References
- 57 Neurologic Disorders of the Larynx
- Laryngologic Manifestations of Neurologic Diseases
- Hyperfunctional Disorders
- Hypofunctional Disorders
- References
- 58 The Professional Voice
- Anatomic Considerations
- Voice Production
- Laryngeal Stroboscopy
- Voice Analysis
- Evaluation
- Problems in Singers
- Performance Cancelation
- Management
- Related Surgical Procedures
- Conclusion
- References
- 59 Laser Surgery
- History of Lasers
- What Is a Laser?
- Control of the Surgical Laser
- Tissue Effects
- Laser Types and Applications
- Pulse Structure
- Lasers in Skin Resurfacing
- Safety Considerations
- References
- 60 Benign Vocal Fold Mucosal Disorders
- Anatomy and Physiology
- Evaluation of the Patient: General Principles
- General Management Options
- Voice Therapy
- Surgery
- Specific Benign Vocal Fold Mucosal Disorders
- Saccular Disorders
- Benign Mesenchymal Neoplasms
- References
- 61 Acute and Chronic Laryngopharyngitis
- Why Does Laryngopharyngitis Matter?
- Acute Laryngopharyngitis
- Noninfectious Causes of Acute Laryngitis
- Chronic Laryngopharyngitis
- Noninfectious Chronic Laryngitis
- Laryngitis Associated With Autoimmune Disease
- Laryngitis Associated With Systemic Inflammatory Disease
- Broad Concepts: the Larynx as a Complex Immunologic Organ
- References
- 62 Medialization Thyroplasty
- Historic Aspects
- Vocal Fold Medialization
- Management of Glottal Insufficiency Associated With Unilateral Vocal Fold Motion Impairment and Soft Tissue Deficits
- Patient Evaluation and Selection
- Vocal Fold Medialization by Injection
- Medialization Thyroplasty
- References
- 63 Arytenoid Adduction and Abduction
- Operative Technique for Arytenoid Adduction
- Future Directions
- References
- 64 Laryngeal Reinnervation
- Introduction
- Physiologic and Anatomic Issues in Laryngeal Reinnervation
- Laryngeal Reinnervation
- Neuromuscular Pedicle
- Ansa Cervicalis–Recurrent Laryngeal Nerve Transfer
- References
- 65 Chronic Aspiration
- Etiology
- Symptoms
- Evaluation
- Nonsurgical Management
- Tracheotomy
- Vocal Cord Medialization
- Surgery
- Summary
- References
- 66 Laryngeal and Esophageal Trauma
- Introduction
- Mechanisms of Injury
- Laryngeal Trauma
- Esophageal Trauma
- References
- 67 Surgical Management of Upper Airway Stenosis
- Pathophysiology
- Classification of Stenosis
- Surgical Principles
- Endoscopic Repair
- Surgical Planning for Open Repair
- Surgical Management of Chronic Stenosis
- Conclusion
- References
- 68 Diseases of the Esophagus
- Esophageal Symptom Assessment
- Esophageal Testing
- Esophageal Disease States Causing Dysphagia
- Other Esophageal Disease States
- Esophageal Manifestations of Systemic Disease
- References
- 69 Transnasal Esophagoscopy
- Comparison With Conventional Endoscopy
- Indications and Clinical Applications
- Patient Preparation
- Technique
- Common Findings
- Monitoring and Postprocedure Care
- Complications
- Conclusion
- References
- 70 Zenker Diverticulum
- Introduction
- Presentation
- Pathophysiology
- Management
- Summary
- References
- 71 Tracheobronchial Endoscopy
- Indications
- Summary
- References
- Part VI Head and Neck Surgery and Oncology
- Section 1 General Considerations
- 72 Fundamentals of Molecular Biology and Gene Therapy
- Fundamentals of Molecular Biology
- Gene Therapy
- Methods of Delivering Gene Therapy
- Why Gene Therapy?
- Applications of Somatic Gene Therapy in Otolaryngology
- Immune Modulation Approaches
- Gene Augmentation Strategies
- Gene Suppression Strategies
- Oncolytic Viruses
- Conclusion
- References
- 73 Biology of Head and Neck Cancers
- Introduction
- Dysregulated Signaling Pathways
- Epigenetics
- Tumor Microenvironment
- Interactions With the Immune System
- Conclusion
- References
- 74 Human Papillomavirus and the Epidemiology of Head and Neck Cancer
- Epidemiology of Oral Human Papillomavirus Infection
- Epidemiology of Human Papillomavirus-Positive Oropharyngeal Squamous Cell Cancers
- Future Directions
- References
- 75 Radiotherapy for Head and Neck Cancer
- Basic Physics
- Radiation in Conventional Medicine
- Radiobiology
- Advanced Radiation Technologies
- Radiation Side Effects
- References
- 76 Chemotherapy and Targeted Biologic Agents for Head and Neck Cancer
- Introduction
- Overview of Treatment Strategies in Squamous Cell Carcinoma of the Head and Neck
- Combined-Modality Therapy
- Systemic Chemotherapy for Recurrent or Metastatic Disease
- Advanced Nonmelanoma Skin Cancers (NMSC) and Use of Systemic Chemotherapy
- Summary
- Acknowledgement
- References
- 77 Skin Flap Physiology and Wound Healing
- Skin Flap Physiology
- Wound Healing
- References
- 78 Free Tissue Transfer
- Introduction
- Historical Perspectives
- Indications for Free Tissue Transfer
- Patient Evaluation and Preparation
- Intraoperative Management
- Surgical Techniques
- Postoperative Management
- Costs and Outcomes
- Future Directions in Free Tissue Transfer
- References
- 79 Integrating Palliative and Curative Care Strategies in the Practice of Otolaryngology
- Palliative Surgery
- Palliative Chemotherapy
- Palliative Radiation Therapy
- References
- 80 Management of Cutaneous Head and Neck Melanoma
- Introduction
- Epidemiology
- Etiology and Risk Factors
- Classification of Melanoma
- Diagnostic Workup
- Prognostic Factors and Tumor Staging
- Surgical Management of the Primary Tumor
- Surgical Management of Regional Lymph Nodes
- Radiation Therapy
- Chemotherapy
- Systemic Therapy for Stage IV Melanoma
- Immunotherapy
- Adjuvant Systemic Therapy
- Follow-Up/Surveillance
- References
- Volume II
- Section 2 Salivary Glands
- 81 Physiology of the Salivary Glands
- Principles of Salivary Gland Secretion
- Saliva
- References
- 82 Diagnostic Imaging and Fine-Needle Aspiration of the Salivary Glands
- Anatomy
- Diagnostic Evaluation
- Conclusion
- References
- 83 Inflammatory Disorders of the Salivary Glands
- Sialolithiasis
- Chronic Sialadenitis
- Infections of the Salivary Glands
- Viral Infections of the Salivary Glands
- Granulomatous Infections of the Salivary Glands
- Other Granulomatous Diseases
- Parasitic Salivary Gland Infections
- Noninfectious Inflammatory Diseases of the Salivary Glands
- Summary
- References
- 84 Benign Neoplasms of the Salivary Glands
- Embryology
- Histogenesis of Salivary Gland Neoplasms
- Associated Factors
- Incidence
- Patient Evaluation
- Pleomorphic Adenomas
- Myoepitheliomas
- Basal Cell Adenomas
- Canalicular Adenomas
- Warthin Tumors
- Oncocytoma
- Sebaceous Adenoma
- Sialadenoma Papilliferum
- Sclerosing Polycystic Adenosis
- Other Epithelial Lesions
- Soft Tissue Lesions
- Management of Benign Salivary Gland Neoplasms
- Complications
- References
- 85 Malignant Neoplasms of the Salivary Glands
- Evaluation of the Patient
- Histopathology
- Prognostic Variables
- Treatment
- References
- Section 3 Oral Cavity
- 86 Physiology of the Oral Cavity
- Sensory Function
- Motor Function
- Specialized Sensory Systems: Taste
- References
- 87 Oral Mucosal Lesions
- Red/White Lesions
- Vesiculobullous and Ulcerative Lesions
- Pigmented Lesions
- References
- 88 Odontogenesis, Odontogenic Cysts, and Odontogenic Tumors
- Introduction
- Background
- Summary
- Odontogenic Cysts
- Malignant Odontogenic Tumors and Malignancies Arising in Odontogenic Cysts or Tumors
- Odontogenic Tumors
- Peripheral Ameloblastoma (Extraosseous Ameloblastoma)
- Malignant Ameloblastoma
- Ameloblastic Fibro-Odontoma
- Keratocystic Odontogenic Tumor (Odontogenic Keratocyst, Parakeratinizing Odontogenic Keratocyst)
- Calcifying Cystic Odontogenic Tumor (Calcifying Odontogenic Cyst, Gorlin Cyst)
- Dentinogenic Ghost Cell Tumor (Epithelial Odontogenic Ghost Cell Tumor, Odontogenic Ghost Cell Tumor)
- Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor)
- Odontogenic Myxoma
- Adenomatoid Odontogenic Tumor
- Odontomas
- Squamous Odontogenic Tumor
- Odontoameloblastoma
- References
- 89 Temporomandibular Joint Disorders
- Anatomy
- Diseases and Disorders
- Intracapsular Disorders
- Temporomandibular Joint Surgery
- Myofascial Pain Dysfunction Syndrome
- Summary
- References
- 90 Benign Tumors and Tumor-Like Lesions of the Oral Cavity
- Congenital Conditions
- Inflammatory/Traumatic Conditions
- Benign Neoplasms
- References
- 91 Malignant Neoplasms of the Oral Cavity
- Risk Factors
- Anatomy of the Oral Cavity
- Pathology
- Diagnostic Evaluation
- Staging
- Prognostic Metrics
- Treatment Considerations
- Surgical Treatment of the Primary Lesion
- Long-Term Management and Rehabilitation
- Summary
- References
- 92 Reconstruction of the Mandible
- Introduction
- Anatomy
- Goals of Mandibular Reconstruction
- Fibular Free Flap Planning
- Formation of the NeoMandible
- Outcomes
- Complications
- Summary
- References
- 93 Prosthetic Management of Head and Neck Defects
- Maxillofacial Prosthetics and the Radiation Oncology Patient
- Dental Diagnoses and Oral Surgical Management Preceding Radiation Therapy
- Dental Management During Radiation Therapy
- Dental Management After Radiation Therapy
- Overview of Maxillofacial Prosthodontic and Radiation Oncology Interactions
- Prosthetic Management of Oral Deficits
- Maxillary Reconstruction With Microvascular Grafting
- Contemporary Planning of Mandibular Defects
- Prosthetic Management of Anatomic Facial Deficits
- Illustrations Exemplifying the Stepwise Process by Which a Nasal Prosthesis Is Constructed
- Illustrations Exemplifying the Stepwise Process by Which an Auricular Prosthesis Implant Guide Is Constructed
- Illustrations Exemplifying the Stepwise Process by Which an Auricular Prosthesis Is Constructed
- Illustrations Exemplifying the Stepwise Process by Which an Orbital Prosthesis Is Constructed
- References
- 94 Malignancies of the Paranasal Sinus
- Introduction
- Epidemiology
- Pathology
- Genomics of Paranasal Sinus Cancers
- Presentation and Diagnosis
- Staging
- Management
- Surgical Approaches
- Reconstruction
- Complications
- Outcomes and Predictors of Outcome
- Endoscopic Endonasal Sinonasal Cancer Surgery
- Limits and Contraindications of Endoscopic Sinonasal Cancer Resections
- Endoscopic Endonasal Reconstruction
- Endoscopic Surgery Outcomes
- Conclusion
- Acknowledgment
- References
- Section 4 Pharynx and Esophagus
- 95 Benign and Malignant Tumors of the Nasopharynx
- Diagnostic Approach for Nasopharyngeal Masses
- Chordoma
- References
- 96 Malignant Neoplasms of the Oropharynx
- Anatomy of the Oropharynx
- Pathology
- Squamous Cell Carcinoma
- Diagnostic Evaluation
- Therapeutic Management and Outcome
- Surgical Approaches
- Complications
- Prognostic Factors
- Unknown Primary
- Function and Quality of Life
- Special Treatment Considerations and Future Directions
- References
- 97 Transoral Approaches to Malignant Neoplasms of the Oropharynx
- Anatomy
- Historical Perspective
- Transoral Case Selection
- Transoral Surgical Approach
- Transoral Surgical Procedures
- Transoral Oropharyngeal Reconstruction
- Postoperative Care
- Functional Outcomes
- Future Research, Goals, and Applications
- Conclusion
- References
- 98 Reconstruction of the Oropharynx
- Options for Reconstruction
- Site-Specific Defects
- Reconstruction After Transoral Oropharyngeal Resection
- Conclusions
- References
- 99 Swallowing Function and Implications in Head and Neck Cancer
- Introduction
- Oral Preparatory Phase
- Oral Phase
- Pharyngeal Phase
- Signs and Symptoms of Abnormal Swallow Associated With Head and Neck Cancer
- Evaluation of Swallowing Disorders
- Evaluation of Swallowing
- Swallowing Disorders Arising From Head and Neck Cancer Treatment
- Posttreatment Complications
- Summary
- References
- 100 Diagnostic Imaging of the Pharynx and Esophagus
- Techniques
- Radiologic Anatomy
- Motility Disorders
- Gastroesophageal Reflux Disease
- Diverticula
- Infection and Inflammation
- Esophageal Narrowing
- Fistulae
- Varices
- Foreign Body
- Mass Lesions
- Posttreatment Imaging
- References
- 101 Neoplasms of the Hypopharynx and Cervical Esophagus
- Anatomy of the Hypopharynx and Cervical Esophagus
- Epidemiology
- Etiology and Biology
- Clinical Evaluation
- Imaging
- Pathology
- Location of Tumors and Patterns of Spread
- Staging
- Management
- Management of the Neck
- Quality of Life
- Summary
- References
- 102 Radiotherapy and Chemotherapy of Squamous Cell Carcinomas of the Hypopharynx and Esophagus
- Introduction
- Hypopharyngeal Cancer: General Principles
- Treatment of Early-Stage Hypopharyngeal Squamous Cell Carcinoma
- Historical Treatment of Advanced Hypopharyngeal Squamous Cell Carcinoma
- Chemotherapy in Surgically Treated Hypopharyngeal Squamous Cell Carcinoma
- Larynx-Preserving Treatment Strategies
- Sequencing of Chemotherapy for Advanced Hypopharyngeal Squamous Cell Carcinoma
- Role of Altered Fractionation in Radiotherapy for Advanced Hypopharyngeal SCC
- Radiotherapy Techniques for Hypopharyngeal Squamous Cell Carcinoma
- Immune Checkpoint Inhibitors
- Esophageal Cancer: General Principles
- Treatment of Early-Stage Esophageal Squamous Cell Carcinoma
- Treatment of Locoregionally Advanced Esophageal SCC
- Nonsurgical Treatment in Inoperable Patients
- Nonsurgical Treatment in Operative Patients
- Chemotherapeutic Regimens for Locoregionally Advanced Esophageal SCC
- Treatment of Locoregionally Advanced Cervical Esophageal SCC
- References
- 103 Reconstruction of the Hypopharynx and Esophagus
- Patient Population at Presentation
- Perioperative Counseling
- Preoperative Evaluation
- Goals and Principles of Reconstruction
- Defect Classification
- Reconstructive Decision Making
- Local and Regional Skin Flaps
- Myocutaneous Flaps
- Visceral Transposition
- Gastric Transposition
- Colonic Transposition
- Revascularized Free Tissue Transplantation
- Fasciocutaneous Transplantation
- Enteric Transplantation
- Gastroomental Donor Site
- Management of Postsurgical Complications
- Voice Rehabilitation
- Posttreatment Speech and Swallowing Outcomes
- Summary
- Acknowledgments
- References
- Section 5 Larynx
- 104 Diagnostic Imaging of the Larynx
- Normal Airway
- Inflammatory Disease of the Larynx
- Laryngomalacia
- Vocal Cord Paralysis
- Benign Laryngeal Masses
- Laryngeal Carcinoma
- Laryngeal Trauma
- Foreign Bodies
- References
- 105 Malignant Tumors of the Larynx
- Anatomy and Embryology
- Classification of Malignant Tumors of the Larynx
- Staging
- Precursor Laryngeal Lesions: Dysplasia
- Squamous Cell Carcinoma of the Larynx
- Epidemiology
- Molecular Biology
- Pathology
- Clinical Presentation
- Diagnosis and Evaluation
- Differential Diagnosis
- Treatment of Squamous Cell Carcinoma
- Treatment of Glottic Squamous Cell Carcinoma
- Treatment of Supraglottic Squamous Cell Carcinoma
- Subglottic Squamous Cell Carcinoma
- Nonsurgical Treatment of Advanced Laryngeal Cancer (Organ Preservation)
- Treatment of Recurrent or Residual Squamous Cell Carcinoma
- Prognosis and Prognostic Predictors
- Variants of Squamous Cell Carcinoma
- Nonsquamous Malignant Laryngeal Tumors
- Secondary Tumors of the Larynx
- References
- 106 Management of Early Glottic Cancer
- Background
- Diagnosis
- Background
- Treatment
- Choosing a Treatment Modality
- Summary
- References
- 107 Transoral Laser Microresection of Advanced Laryngeal Tumors
- Terms and Definitions
- Five Types of Local Laryngeal Cancer
- Acronyms
- Laser Surgery and Transoral Laser Microsurgery in the Treatment of Locally Early, Intermediate, and Advanced Cancers
- Theoretic Basis of Transoral Laser Microsurgery
- Transoral Laser Microsurgery Compared With Open Conservation Surgery
- Instrumentation and Techniques of Transoral Laser Microsurgery
- Evolution of Potassium Titanyl Phosphate Laser Microsurgery
- Pathology Issues
- Transoral Laser Microsurgery in Relation to Each of the Five Clinical Categories of Laryngeal Cancer Stratified by Local Extent
- Total Laser Microresection and Neck Dissection
- Total Laser Microresection and Recurrent Disease
- Voice Outcomes and Phonosurgical Reconstruction
- Voice Therapy
- Complications of Transoral Laser Microresection
- Contraindications to Transoral Laser Microresection
- Results of Transoral Laser Microresection
- Göttingen Group Results
- Conclusions
- Future Directions
- Appendix on the Clinical Classification Used in This Chapter
- References
- 108 Conservation Laryngeal Surgery
- Conservation Laryngeal Surgery Today
- Anatomy, Physiology, and Tumor Spread
- Principles of Organ-Preservation Surgery
- Preoperative Evaluation
- Surgical Techniques
- Organ-Preservation Surgery Spectrum for Glottic and Supraglottic Cancer
- Postoperative Management Issues
- Future Developments
- Summary
- References
- 109 Total Laryngectomy and Laryngopharyngectomy
- Total Laryngectomy
- Total Laryngopharyngectomy
- Summary
- References
- 110 Radiation Therapy for Cancer of the Larynx and Hypopharynx
- Overall Synopsis
- Overview
- Anatomy of the Larynx and Hypopharynx
- Biomarkers and Molecular Biology
- Clinical Presentation and Evaluation
- Laryngeal Cancers
- Hypopharyngeal Cancers
- Future Strategies and Directions
- References
- 111 Vocal and Speech Rehabilitation After Laryngectomy
- History of Alaryngeal Voice and Speech
- Physiology of Alaryngeal Voice and Speech
- Types of Voice Prostheses
- Surgical Aspects of Alaryngeal Voicing
- Postoperative Management
- Voice Prosthesis Replacement and Maintenance
- Troubleshooting the Prosthetic Voice
- Voice and Speech Therapy
- Pulmonary Care and Rehabilitation
- Prevention Aspects
- Olfaction Rehabilitation
- Quality of Life After Total Laryngectomy
- References
- 112 Diagnosis and Management of Tracheal Neoplasms
- Overview
- Historic Review
- Primary Tracheal Tumors
- Benign Primary Tracheal Tumors
- Malignant Primary Tracheal Neoplasms
- Secondary Tracheal Tumors
- Diagnosis
- Staging
- Treatment
- Benign Tracheal Tumors
- Palliative Treatment of Unresectable Malignant Tracheal Tumors
- Summary
- References
- Section 6 Neck
- 113 Differential Diagnosis of Neck Masses
- History and Physical Examination
- Anatomy
- Diagnostic Testing
- Potential Etiologies of Neck Masses
- Summary
- References
- 114 Ultrasound Imaging of the Neck
- Basics of Ultrasonography
- Conclusion
- References
- 115 Neoplasms of the Neck
- Introduction
- Diagnostic Evaluation
- Benign Neoplasms of the Neck
- Benign Lesions of the Parapharyngeal Space
- Malignant Neoplasms of the Neck
- Metastatic Lesions to the Neck
- Primary Malignant Tumors of the Neck
- Summary
- References
- 116 Lymphomas Presenting in the Head and Neck
- Introduction
- Epidemiology
- Clinical Presentation of Lymphomas of the Head and Neck
- Biopsy Techniques and Specimen Handling
- Nodal Lymphomas of the Head and Neck
- Summary
- Acknowledgment
- References
- 117 Radiation Therapy and Management of the Cervical Lymph Nodes and Malignant Skull Base Tumors
- Lymphatic System of the Neck
- Staging of Neck Node Metastasis
- Neck Node Delineation and Irradiation Techniques
- Radiation Therapy and Malignant Skull Base Tumors
- Radiation: Technical Advances
- Treatment of Malignant Cranial Base Tumors
- Complications After Skull Base Irradiation
- References
- 118 Neck Dissection
- Historical Perspective
- Cervical Lymph Node Groups
- Division of Neck Levels by Sublevels
- Results of Neck Dissection
- Sequelae of Neck Dissection
- Complications of Neck Dissection
- Neck Dissection After Treatment With Chemoradiation
- Neck Dissection in the Era of Transoral Surgery
- Minimally Invasive Neck Dissection
- Summary
- References
- 119 Complications of Neck Surgery
- Wound Complications
- Vascular Complications
- Nerve Complications
- Chyle/Chest
- Conclusion
- References
- 120 Penetrating and Blunt Trauma to the Neck
- Physical Properties of Penetrating Objects
- Mandatory Versus Elective Exploration
- Diagnostic Evaluation
- Angiography
- Management of Vascular Penetration
- Digestive Tract Evaluation
- Management of Laryngotracheal Injury
- Blunt Neck Trauma
- Summary
- References
- Section 7 Thyroid/Parathyroid
- 121 Disorders of the Thyroid Gland
- Physical Examination
- Physiology of the Thyroid Gland
- Thyroid Function Studies
- Thyrotoxicosis
- Hypothyroidism
- References
- 122 Management of Thyroid Neoplasms
- Surgical Anatomy and Embryology
- Molecular Basis for Thyroid Neoplasms
- Molecular Diagnostics and Targeted Therapies
- Risk Factors and Etiology
- Tumor Staging and Classification
- Evaluation of a Thyroid Nodule
- Review of Thyroid Neoplasms
- Surgical Management and Technique
- Postoperative Management and Special Considerations
- Follow-Up Management
- Summary
- References
- 123 Management of Parathyroid Disorders
- History of the Parathyroid Glands
- Calcium Physiology
- Parathyroid Anatomy
- Embryology
- Primary Hyperparathyroidism
- Surgical Management
- Surgical Treatment
- Secondary Hyperparathyroidism
- Tertiary Hyperparathyroidism
- Nonsurgical Management
- Permanent Hypoparathyroidism
- Summary
- References
- 124 Surgical Robotics in Otolaryngology
- History of Robotics
- Definitions
- History of Medical Robotics
- Laryngeal and Hypopharyngeal Robotic Surgery
- Obstructive Sleep Apnea
- Conclusion
- References
- 125 Management of Thyroid Eye Disease (Graves Ophthalmopathy)
- Epidemiology and Impact
- Pathophysiology
- Genetics and Sex
- Nongenetic Factors
- Thyroid Status
- Natural History
- Clinical Features
- Clinical Evaluation
- Treatment: Medical Therapy
- Radiotherapy
- Thyroidectomy for Graves Ophthalmopathy
- Surgical Therapy for Graves Ophthalmopathy
- Summary
- References
- Part VII Otology, Neurotology, and Skull Base Surgery
- Section 1 Basic Science
- 126 Anatomy of the Temporal Bone, External Ear, and Middle Ear
- Osteology of the Temporal Bone
- External Ear
- Tympanic Membrane
- Middle Ear
- Facial Nerve
- Mastoid and Other Pneumatized Regions of the Temporal Bone
- References
- 127 Neuroanatomy of the Auditory System
- Cochlear Anatomy
- Central Auditory Pathways
- Acknowledgments
- References
- 128 Physiology of the Auditory System
- Sound and Its Measurement
- Impedance
- External Ear
- Middle Ear Mechanics
- Inner Ear Physiology
- Auditory Nerve
- Auditory Brainstem and Midbrain
- Thalamus and Auditory Cortex
- Efferent Auditory System
- Summary
- Acknowledgments
- References
- 129 Anatomy of the Vestibular System
- Embryology of the Vestibular Apparatus
- Overall Organization of the Labyrinth: Relationship to Skull and Cochlea
- Efferent Innervation of the Peripheral Vestibular Apparatus
- Autonomic Supply of the Peripheral Vestibular Apparatus
- Blood Supply to Vestibular End Organs
- End-Organ Anatomy
- Cellular Morphology of Vestibular Sensory Epithelium
- Synaptic Morphology of Vestibular Afferents
- Morphology and Function of Vestibular Afferents
- Central Pathways of the Vestibular System
- References
- 130 Anatomy and Physiology of the Eustachian Tube
- Embryology and Postnatal Development
- Anatomy
- Physiology
- Summary
- References
- 131 Clinical Evaluation and Management of the Eustachian Tube
- Introduction
- Eustachian Tube Function Tests
- Obstructive Eustachian Tube Dysfunction
- Obstructive Eustachian Tube Dysfunction Management
- Other Interventions for Dilatory Eustachian Tube Dysfunction
- References
- 132 Cortical Neuroplasticity in Hearing Loss
- Introduction
- Neuroplasticity in Pediatric Hearing Loss
- Neuroplasticity in Adult-Onset, Age-Related Hearing Loss
- Summary
- References
- 133 Geriatric Otology
- Aging
- Older Adults and Hearing Loss
- Older Adults and Vestibular Dysfunction
- Conclusion
- References
- Section 2 Diagnostic Assessment
- 134 Diagnostic Audiology and Electrophysiologic Assessment of Hearing
- Audiologic Test Battery
- Tests to Evaluate Middle-Ear Function
- Objective Tests for Differential Diagnostic Applications
- Neurodiagnosis With the Auditory Brainstem Response
- Neurodiagnostic Studies in Patients With Auditory Neuropathy/Dyssynchrony
- Sources of Error in Audiologic Testing
- References
- 135 Neuroradiology of the Temporal Bone and Skull Base
- Normal Anatomic Variations
- Pathologic Conditions
- References
- 136 Interventional Neuroradiology of the Skull Base, Head, and Neck
- Materials and Techniques
- Endovascular Treatment of Neoplasms
- Lesions of Vascular Etiology
- References
- 137 Otologic Symptoms and Syndromes
- The Otologic History
- Hearing Loss
- Tinnitus
- Otalgia and Ear Fullness
- Otorrhea
- Vertigo
- The Otologic Physical Exam
- References
- Section 3 External Ear
- 138 Infections of the External Ear
- Introduction
- Anatomy of the External Ear
- Otitis Externa
- Malignant Otitis Externa
- Herpes Zoster Oticus
- Bullous Myringitis
- Chondritis, Perichondritis, and Cellulitis of the Auricle
- Erysipelas
- Furunculosis
- Keratosis Obturans and Cholesteatoma of the External Auditory Canal
- References
- 139 Topical Therapies of External Ear Disorders
- References
- Section 4 Middle Ear, Mastoid, and Temporal Bone
- 140 Chronic Otitis Media, Mastoiditis, and Petrositis
- Effects on Mastoid Pneumatization
- Middle Ear Atelectasis and Adhesive Otitis Media
- Chronic Otitis Media With Cholesteatoma
- Chronic Otitis Media Without Cholesteatoma
- Bone Erosion in Cholesteatoma and Chronic Otitis Media
- Sensorineural Hearing Loss
- Tympanosclerosis
- Petrositis
- Summary
- References
- 141 Complications of Temporal Bone Infections
- Epidemiology
- Pathophysiology
- Diagnosis
- Treatment
- Extracranial (Intratemporal) Complications
- Intracranial Complications
- References
- 142 Tympanoplasty and Ossiculoplasty
- Tympanoplasty
- Ossiculoplasty
- References
- 143 Mastoidectomy
- History
- Relevant Anatomy
- Nomenclature
- Intact Versus Canal Wall–Down Mastoidectomy: Advantages and Disadvantages
- Indications for Intact Versus Canal Wall–Down Procedures
- Mastoid Obliteration
- Revision Surgery
- Otoendoscopy and Mastoidectomy
- Canal Reconstruction Mastoidectomy
- Retrograde Mastoidectomy
- Complications
- Mastoidectomy: New Paradigms in Training and Simulation
- References
- 144 Middle Ear Endoscopic Surgery
- Introduction
- Initial Considerations
- Equipment Considerations
- Basic Endoscopic Technique
- Endoscopic Ear Anatomy
- Conclusion
- References
- 145 Clinical Assessment and Surgical Treatment of Conductive Hearing Loss
- Mechanical Properties of the Conductive Hearing Pathway
- Diagnostic Evaluation
- Treatment
- The Expanding Role of Implantable Devices
- Management of Conductive Hearing Loss in Children
- Conclusion
- Acknowledgments
- References
- 146 Otosclerosis
- Histopathology
- Evaluation
- Surgery
- Variations of Surgical Technique
- Surgical Problems
- Postoperative Complications
- Alternative Treatment
- Special Considerations
- Summary
- References
- 147 Management of Temporal Bone Trauma
- Epidemiology
- Pathophysiology
- Classification
- Evaluation
- Management of Complications
- References
- Volume III
- Section 5 Inner Ear
- 148 Cochlear Transduction and the Molecular Basis of Auditory Pathology
- Passive Cochlear Mechanics
- Active Cochlear Mechanics
- Hair Cell Transduction
- Perilymphatic-Endolymphatic Barrier
- Endolymph Homeostasis
- Summary
- Acknowledgments
- References
- 149 Genetics of Ear Disorders
- The Genome
- DNA Structure and the Genetic Code
- Gene Structure and Expression
- Molecular Basis of Patterns of Inheritance
- Chromosomal Disorders
- Single-Gene Disorders
- Oligogenic Disorders
- Mitochondrial Disorders
- Testing Human DNA
- Ethical Issues
- Utility of Molecular Genetics in Otolaryngology
- References
- 150 Genetic Sensorineural Hearing Loss
- Background
- Genetic Hearing Impairment
- Syndromic Hearing Impairment
- Patient Management
- Acknowledgments
- References
- 151 Otologic Manifestations of Systemic Disease
- Granulomatous and Infectious Diseases
- Neoplastic Diseases
- Diseases of the Bone
- Storage and Metabolic Diseases
- Collagen Vascular and Autoimmune Diseases
- Immunodeficiency and Immune-Mediated Disorders
- Genetically Determined Defects
- References
- 152 Sensorineural Hearing Loss in Adults
- Clinical Evaluation of the Patient With Hearing Loss
- Etiology of Sensorineural Hearing Loss
- Sudden Sensorineural Hearing Loss
- Conclusions
- References
- 153 Tinnitus and Hyperacusis
- Tinnitus
- History and Physical Examination
- Subjective Nonpulsatile Tinnitus
- Pulsatile Tinnitus
- Conclusion
- References
- 154 Noise-Induced Hearing Loss
- Measurement of Noise
- Nature of the Hearing Loss
- Research on Noise-Induced Hearing Loss
- New Knowledge About Cellular and Molecular Mechanisms of Noise-Induced Hearing Loss
- Early Detection of Noise-Induced Hearing Loss
- Interactive Effects
- Adverse Vestibular Effects Caused by Noise
- Other Adverse Effects Caused by Noise
- Legal Issues
- Role of the Otolaryngologist
- Summary
- Acknowledgments
- References
- 155 Infections of the Labyrinth
- Background Anatomy and Physiology
- Perinatal Labyrinthine Infections
- Acknowledgments
- References
- 156 Autoimmune Inner Ear Disease
- Introduction
- Epidemiology
- Pathology and Pathogenesis
- Diagnosis
- Treatment of Primary Autoimmune Inner Ear Disease
- Systemic Autoimmune Diseases Associated With Hearing Loss
- Conclusion
- References
- 157 Vestibular and Auditory Ototoxicity
- Aminoglycoside Antibiotics
- Antineoplastic Agents
- Difluoromethylornithine
- Loop diuretics
- Analgesics
- Quinine and Related Drugs
- Erythromycin and Related Macrolide Antibiotics
- Deferoxamine
- Ototoxicity Monitoring for Hearing Loss
- References
- 158 Pharmacologic and Molecular Therapies of the Cochlear and Vestibular Labyrinths
- Pathway to the Inner Ear
- Round Window Membrane
- Steroids
- Gentamicin
- Otoprotective Agents
- Gene Therapy
- References
- Section 6 Auditory Prosthetic Stimulation, Devices, and Rehabilitative Audiology
- 159 Implantable Hearing Devices
- Introduction
- Limitations of Auditory Rehabilitation Using Traditional Hearing Aids
- The Promise of Implantable Hearing Devices
- Middle Ear Implants
- Electromagnetic Middle Ear Implantable Hearing Devices
- Piezoelectric Middle Ear Implantable Hearing Devices
- Osseointegrated Bone-Conducting Hearing Prostheses
- Osseointegrated Bone-Conducting Hearing Prostheses for Unilateral Sensorineural Hearing Loss
- Conclusion
- References
- 160 Cochlear Implantation
- General Background
- Patient Evaluation
- Evaluation of Adult Candidates for Cochlear Implants
- Device Selection
- References
- 161 Medical and Surgical Considerations in Cochlear Implantation
- Medical and Surgical Evaluation
- Ear Selection
- Vaccination for Meningitis
- Surgical Technique
- Hearing Conservation
- Ossified Cochlea
- Complications
- References
- 162 Cochlear Implantation in Adults
- Overview
- Candidacy
- Prevention With Vaccination
- Predictors of Benefit in Adults
- Cochlear Implantation With Hearing Preservation in Adults
- Bilateral Cochlear Implantation in Adults
- Results of Implantation
- Outcomes After Cochlear Implantation
- Auditory Rehabilitation After Cochlear Implantation
- References
- 163 Auditory Brainstem Implantation
- Introduction
- History
- Device Hardware
- Candidacy Evaluation
- Radiographic Assessment
- Surgical Anatomy
- Operative Technique
- Postoperative Management
- Complications
- Outcomes
- Summary
- References
- 164 Hearing Aid Amplification
- Indications for Hearing Aid Use
- Hearing Aid Technology
- Selection and Fitting Process
- Special Considerations Based on Patient Age
- Hearing Aids: Some Rules of Thumb
- References
- Section 7 Vestibular Disorders
- 165 Principles of Applied Vestibular Physiology
- Principles
- Appendix
- Acknowledgments
- References
- 166 Evaluation of the Patient With Dizziness
- Background
- Fundamentals of Vestibular Function
- Approach to the Patient With Dizziness
- Adaptive Capabilities of the Vestibular System
- References
- 167 Peripheral Vestibular Disorders
- Basic Principles of Peripheral Vestibular Physiology
- Clinical Relevance
- Historical Background
- Benign Paroxysmal Positional Vertigo
- Vestibular Neuritis
- Ménière Disease (Idiopathic Endolymphatic Hydrops)
- Superior Canal Dehiscence Syndrome
- Cogan Syndrome
- Otosyphilis
- Perilymph Fistulas
- Trauma
- Bilateral Vestibular Hypofunction
- Enlarged Vestibular Aqueduct
- References
- 168 Central Vestibular Disorders
- Introduction
- Intracranial Complications of Otitic Infections
- Persistent Postural-Perceptual Dizziness
- Vascular Disorders
- Neoplasms
- Cervical Vertigo
- Disorders of the Craniovertebral Junction
- Multiple Sclerosis
- Cerebellar Ataxia Syndromes
- Focal Seizure Disorders
- Normal Pressure Hydrocephalus
- Physiologic Dizziness
- References
- 169 Surgery for Vestibular Disorders
- Rationale for Surgery
- Procedures for Benign Paroxysmal Positional Vertigo
- Surgery for Superior Semicircular Canal Dehiscence
- Repair of a Perilymphatic Fistula
- Specific Operations for Ménière Disease
- Patient Selection in Ablative Vestibular Surgery
- Ablative Procedures for Control of Vertigo
- Postoperative Vestibular Compensation
- References
- 170 Vestibular and Balance Rehabilitation Therapy
- Physiologic Rationale for Vestibular and Balance Rehabilitation
- Assessment of Vestibular Compensation
- Vestibular Rehabilitation: Patient Selection Criteria
- Role of Outcome Measures
- Vestibular Rehabilitation: Common Techniques
- Vestibular Rehabilitation: Expected Results
- Acknowledgment
- References
- Section 8 Facial Nerve Disorders
- 171 Tests of Facial Nerve Function
- Physical Examination
- Pathophysiology
- Imaging
- Electrodiagnostic Testing
- Unconventional Tests of Facial Nerve Function
- Topognostic Tests
- References
- 172 Clinical Disorders of the Facial Nerve
- Bell Palsy: Spontaneous Idiopathic Facial Paralysis
- Facial Reanimation
- Special Cases of Facial Paralysis
- Facial Paralysis Associated With Other Conditions
- Central Facial Paralysis
- References
- 173 Intratemporal Facial Nerve Surgery
- Surgical Anatomy
- General Surgical Technique
- Surgical Approaches
- Nerve Repair
- References
- 174 Rehabilitation of Facial Paralysis
- Evaluation of Facial Paralysis
- Goals of Facial Reanimation
- Facial Nerve Repair and Grafting
- Approach to Upper Face Reanimation
- Approach to Midfacial Reanimation
- Approach to Reanimation of the Lower Face
- Adjunctive Aesthetic Procedures
- References
- Section 9 Cranial Base
- 175 Surgical Anatomy of the Lateral Skull Base
- Osseous Anatomy of the Lateral Skull Base
- Anatomy of the Middle Cranial Fossa
- Anatomy of the Posterior Cranial Fossa
- Anatomy of the Infratemporal Fossa
- References
- 176 Surgery of the Anterior and Middle Cranial Base
- Introduction
- Surgical Anatomy
- Preoperative Considerations
- Operative Techniques
- Reconstruction
- Postoperative Concerns
- Outcomes
- References
- 177 Transnasal Endoscopic-Assisted Surgery of the Anterior Skull Base
- Surgical Anatomy
- Preoperative Assessment
- Operative Technique
- Instrumentation
- Transnasal Surgical Approaches to the Skull Base
- Reconstruction
- Postoperative Care
- Complications
- Summary
- References
- 178 Temporal Bone Neoplasms and Lateral Cranial Base Surgery
- Introduction
- Diagnosis of Neoplasms of the Temporal Bone
- Common Neoplasms of the Temporal Bone
- Benign Neoplasms of the Temporal Bone
- Malignant Neoplasms of the Temporal Bone
- Lateral Skull Base Surgery
- Complications
- References
- 179 Neoplasms of the Posterior Fossa
- Approach to Diagnosis of Neoplasms of the Posterior Fossa
- Common Cerebellopontine Angle Neoplasms
- Petrous Apex Lesions
- Miscellaneous Cerebellopontine Angle Lesions
- Intraaxial Tumors
- Surgery of the Posterior Cranial Fossa
- Selection of Surgical Approach
- Patient Management and Surgical Complications
- Selection of Neoplasm Treatment Strategy
- References
- 180 Intraoperative Monitoring of Cranial Nerves in Neurotologic Surgery
- Technical Considerations
- Anesthesia
- Facial Nerve (7th Nerve) Monitoring
- Other Methods of Motor Nerve Monitoring
- Cochlear (8th) Nerve Monitoring
- Auditory Brainstem Response Recording in the Operating Room
- Conclusion
- References
- 181 Radiation Therapy of Benign Tumors of the Cranial Base
- Principles of Stereotactic Radiation
- Imaging
- Treatment of Tumors of the Cranial Base: Review of Stereotactic Radiation for Vestibular Schwannomas
- Dose Selection
- Vestibular Schwannoma Related to Neurofibromatosis Type 2
- Cystic Schwannomas
- Complications and Failures
- Jugular Foramen Schwannomas
- Paraganglioma
- Conclusions
- References
- Part VIII Pediatric Otolaryngology
- Section 1 General
- 182 General Considerations in Pediatric Otolaryngology
- Introduction
- Pediatric Otolaryngology Practice
- Conclusion
- References
- 183 Pediatric Speech Disorders
- Speech Sound Disorders
- Language Disorders
- Overlap With Other Disorders
- Role of Pediatric Otolaryngology
- Where to Refer
- References
- 184 Anesthesia in Pediatric Otolaryngology
- Introduction and General Considerations
- Preoperative Anesthetic and Risk Assessment
- Anesthetic Considerations for Common Pediatric Diseases
- Preoperative Management
- Intraoperative Management
- Postoperative Management
- Conclusion
- References
- 185 Nonobstructive Pediatric Sleep Disorders
- Dyssomnias
- Parasomnias
- Pediatric Neuropsychiatric Disorders and Sleep Disruption
- References
- 186 Evaluation and Management of Pediatric Obstructive Sleep Apnea
- Historical Perspective
- Definitions
- Etiology and Pathogenesis
- Epidemiology
- Clinical Features
- Predisposing Conditions
- Physical Examination
- Ancillary Studies
- Natural History
- Treatment
- References
- Section 2 Craniofacial
- 187 Craniofacial Surgery for Congenital and Acquired Deformities
- Epidemiology
- Craniofacial Growth
- Pathophysiology
- Metabolic Disorders
- Intrauterine Causes
- Acquired Craniofacial Deformities
- Clinical Manifestations
- Trauma
- Neoplasm
- Patient Evaluation
- History and Physical Examination
- Imaging
- Indications for and Timing of Intervention
- Surgical Techniques
- Controversies and Evidence-Based Medicine in Primary Craniosynostosis Surgery
- Biomaterials in Skeletal or Cartilaginous Defect Repair
- Conclusion
- References
- 188 Cleft Lip and Palate
- Introduction
- Classification of Cleft Lip and Palate
- Embryology
- Diagnosis
- Molecular Genetics of Orofacial Clefts
- Multidisciplinary Cleft Team
- Nursing Care
- Anatomy
- Presurgical Considerations
- Cleft Lip Repair and Cleft Rhinoplasty
- Cleft Palate Repair
- Special Considerations in Patients With Cleft Palate
- Microdeletion 22q11.2 Syndrome
- References
- 189 Velopharyngeal Dysfunction
- References
- 190 Congenital and Acquired Malformations of the Nose and Nasopharynx
- Developmental Errors of the Anterior Neuropore
- Encephaloceles
- Gliomas
- Nasal Dermoids
- Developmental Errors of the Central Midface
- Complete Agenesis of the Nose (Arhinia)
- Polyrhinia and Supernumerary Nostril
- Proboscis Lateralis
- Craniofacial Clefts
- Cleft Lip Nasal Deformity
- Congenital Stenosis of the Nasal Piriform Aperture
- Nasolacrimal Duct Cysts
- Developmental Errors of the Nasobuccal Membrane
- Choanal Atresia
- Other Mesodermal and Germline Malformations
- References
- 191 Pediatric Facial Fractures
- Introduction
- Epidemiology
- Diagnosis
- General Management Principles
- Frontal Fractures
- Orbital Fractures
- Midface Fractures
- Nasal Fractures and Nasal Septal Injury
- Dentoalveolar Trauma
- Mandible Fractures
- Condylar Fractures
- Symphysis and Parasymphysis Fractures
- Angle and Body Fractures
- Postoperative Care
- Conclusion
- References
- Section 3 Hearing Loss and Pediatric Otology
- 192 Pediatric Otologic Surgery
- Middle Ear and Mastoid Surgery
- Bone Conduction Devices
- Cochlear Implantation
- Summary
- References
- 193 Early Detection and Diagnosis of Infant Hearing Impairment
- Epidemiology of Hearing Loss
- Status of Hearing Loss Diagnosis Before Universal Newborn Hearing Screening
- History of Newborn Hearing Screening
- Resistance to Newborn Hearing Screening
- Studies of Statewide Screening
- National Newborn Hearing Statements and Current Status of Newborn Hearing Screening
- Newborn Hearing Screening Methods
- Diagnostic Auditory Brainstem Response
- Auditory Steady-State Response
- Behavioral Testing
- Comparison of Methods: Strengths and Limitations
- Evaluation of the Infant With Sensorineural Hearing Loss
- Interpretation of Middle Ear Fluid in the Infant
- Congenital Cytomegalovirus
- Genetic Mutation
- Imaging
- Auditory Neuropathy Spectrum Disorder
- Summary
- Acknowledgments
- References
- 194 Congenital Malformations of the Inner Ear
- Incidence
- Classification
- Malformations Limited to the Membranous Labyrinth
- Malformations of the Membranous and Osseous Labyrinth
- Anomalies of the Eighth Nerve
- Cerebrospinal Fluid Leakage and Meningitis
- Perilymphatic Fistula
- Malformations of the Vascular System
- Inner Ear Malformations in Congenital Aural Atresia
- Imaging
- Evaluation and Management
- Cochlear Implantation
- References
- 195 Microtia Reconstruction
- Introduction
- Embryology
- Anatomy
- Microtia Classification
- Evaluation
- Surgical Planning
- Framework Position Principles
- Autologous Costal Cartilage Reconstruction
- Complications of Autologous Ear Reconstruction
- Future Horizons
- Conclusions
- References
- 196 Pediatric Cochlear Implantation
- Overview
- The Cochlear Implant Team
- Candidacy
- Counseling: Developing “Realistic” Expectations
- Surgical Considerations Relevant to the Pediatric Patient
- Device Activation, Programming, and Follow-Up Assessment
- Auditory Rehabilitation and Cochlear Implantation Outcome
- Children With Special Needs
- Influence of Family Factors on Child Outcomes
- References
- 197 Evaluation and Management of Congenital Aural Atresia
- Demographics and Associated Deformities
- Initial Evaluation
- Timing and Sequence of Surgical Procedures
- Grading System for Atresia Surgery
- Surgical Approach (Figs. 197.8 to 197.15)
- Complications of Atresiaplasty
- Combined Microtia Repair and Atresiaplasty
- Hearing Results Following Atresiaplasty (Tables 197.2 and 197.3)
- Congenital External Auditory Canal Stenosis
- Implantable and Nonimplantable Hearing Devices
- Conclusion
- References
- 198 Evaluation and Management of Pediatric Vestibular Disorders
- Introduction
- Development and Maturation of the Vestibular System
- Development of Motor Control
- Vestibular Disorders in Children
- Benign Paroxysmal Vertigo of Childhood
- Middle Ear Effusion/Otitis Media With Effusion
- Mental Health Disorders
- Vestibular Impairment Related to Sensorineural Hearing Loss
- Ototoxicity
- Acquired Infection
- Unilateral Sensorineural Hearing Loss
- Impact of Cochlear Implantation
- Clinical Evaluation
- Evaluation of Vestibular End-Organ Function
- Behavioral Assessment of Vestibular Function
- Summary
- References
- Section 4 Infections and Inflammation
- 199 Acute Otitis Media and Otitis Media With Effusion
- Diagnosis
- Epidemiology
- Pathophysiology and Pathogenesis
- Prevention
- Treatment
- Surgical Issues
- Complications and Sequelae of Otitis Media
- References
- 200 Pediatric Chronic Rhinosinusitis
- Definition and Clinical Presentation
- Pathophysiology (Box 200.2)
- Comorbid Diseases (Box 200.3)
- Diagnostic Workup
- Medical Treatment
- Ancillary Treatments
- Surgical Treatment
- Summary
- References
- 201 Pediatric Infectious Disease
- Pharyngotonsillitis
- Complications of Tonsillitis
- References
- Section 5 Head and Neck
- 202 Congenital and Inflammatory Neck Masses in Children
- Introduction
- Embryology
- Derivatives of the Pharyngeal Pouches
- Development of the Tongue
- Development of the Thyroid Gland
- Approach to the Evaluation of Pediatric Neck Masses
- Examination
- Common and Important Congenital Pediatric Neck Masses
- Acknowledgments
- References
- 203 Vascular Anomalies of the Head and Neck
- Introduction
- Vascular Tumors
- Hemangioma of Infancy: Treatment Overview
- Vascular Malformations
- Summary
- Acknowledgments
- References
- 204 Pediatric Head and Neck Neoplasms
- Lymphoproliferative Disorders and Histiocytoses
- Neuroectodermal Tumors
- Acknowledgments
- References
- 205 Salivary Gland Disease in Children
- Introduction
- Anatomy and Physiology
- History and Physical Examination
- Evaluation
- Infectious Conditions
- Autoimmune, Inflammatory, and Cystic Lesions
- Salivary Gland Tumors
- Sialorrhea
- Conclusion
- Acknowledgments
- References
- Section 6 Pharynx, Larynx, Trachea, and Esophagus
- 206 Evaluation and Management of the Pediatric Airway
- Assessment of a Child With Noisy Breathing
- Laryngomalacia
- Vocal Fold Dysfunction
- Laryngeal Web and Atresia
- Subglottic Disease
- Cysts
- Summary
- References
- 207 Ankyloglossia and Tight Maxillary Frenula
- Introduction
- Evaluation and Diagnosis
- Tight Maxillary Frenulum (Lip Tie)
- Orthodontic Treatment
- Conclusion
- References
- 208 Recurrent Respiratory Papillomatosis
- Introduction
- Epidemiology
- Virology of Human Papillomavirus
- Transmission
- Prevention
- Clinical Features
- Patient Assessment
- Surgical Management
- Anesthetic Techniques
- Adjuvant Treatment Modalities
- Staging Severity
- Registry and Task Force Initiatives
- Other Considerations
- Summary
- References
- 209 Glottic and Subglottic Stenosis and Related Voice Disorders
- Embryology
- Etiology
- Diagnosis of Laryngeal Stenosis
- Management of Laryngeal Stenosis
- Summary
- References
- 210 Diagnosis and Management of Tracheal Anomalies and Tracheal Stenosis
- Introduction and Embryology
- Endoscopy
- Radiology
- Tracheal Anomalies
- Tracheal Stenosis
- Acknowledgment
- References
- 211 Aerodigestive Foreign Bodies and Caustic Ingestions
- Public Health Impact
- Epidemiology
- Management
- Summary
- References
- 212 Pediatric Swallowing, Laryngopharyngeal and Gastroesophageal Reflux Disease, Eosinophilic Esophagitis, and Aspiration
- Normal Swallowing Physiology
- Clinical Feeding Evaluation of Infants and Young Children
- Instrumental Evaluation of Swallowing
- Management of Infants and Children With Swallowing/Feeding Problems
- Laryngopharyngeal and Gastroesophageal Reflux and Eosinophilic Esophagitis
- Evaluation of Reflux and Eosinophilic Esophagitis
- Clinical Presentation of Gastroesophageal Reflux Disease
- Treatment of Gastroesophageal Reflux Disease and Eosinophilic Esophagitis
- Approach
- Conclusion
- References
- 213 Pediatric Tracheotomy and Decannulation
- Introduction and History
- Indications
- Preoperative Evaluation
- Parental Counseling
- Surgical Technique
- Tracheotomy Versus Tracheostomy
- Postoperative Tracheotomy Care
- Complications
- Decannulation
- Conclusion
- References
- 214 Laryngotracheal Clefts
- Introduction
- Embryology
- Conclusion
- References
- Index
- No. of pages: 3568
- Language: English
- Edition: 7
- Published: May 11, 2020
- Imprint: Elsevier
- Hardback ISBN: 9780323612166
- Hardback ISBN: 9780323611794
PF
Paul W. Flint
Paul W. Flint, MD received his medical degree from Baylor College of Medicine and completed his residency training at the University of Washington. He joined the faculty at Johns Hopkins in 1991, where he served as Residency Training Program Director. In 2009, Dr. Flint was appointed Professor and Chair, Otolaryngology – Head &Neck Surgery at Oregon Health & Science University. He is a founding member of the Society for Airway Management, and an active member of The Triological Society, The American Laryngological Society, The American Academy of Otolaryngology, and The American College of Surgeons. Dr. Flint's clinical interests include the treatment of benign and malignant diseases of the airway, development of procedures to improve voice, swallowing, and breathing; and, treatment of movement disorders affecting the head and neck, including dystonia and Parkinson disease.
Affiliations and expertise
Professor and Chair, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OregonBH
Bruce H. Haughey
Dr. Haughey is a board-certified otolaryngologist with advanced fellowship training in head and neck cancer surgery. He specializes in surgical interventions to address cancers of the throat, vocal cords, sinuses, thyroid, parathyroid, submandibular and salivary glands, neck and skull. His primary clinical interests also include surgery to address skin cancers on the face and neck, including melanoma and facial reconstruction surgeries, as well as microvascular free tissue transfer procedures and laryngeal and sinus disorders. A respected researcher whose work has contributed to the development of new and minimally invasive methods for removing head and neck cancers, Dr. Haughey earned his medical degree at the University of Auckland in New Zealand before completing his residency as Chief Resident, earning a Master of Science in otolaryngology - head and neck surgery and carrying out a prestigious skull base and neuro-otology fellowship, all at the University of Iowa in Iowa City.
Affiliations and expertise
AdventHealth Medical Group Otolaryngology and Head & Neck Surgery at CelebrationVL
Valerie J. Lund
Valerie Lund is Professor Emeritus of Rhinology at the Ear Institute, University College London and is an Honorary Consultant ENT Surgeon at the Royal National Throat Nose and Ear Hospital (University College London Trust), University College Hospital. She deals with all nose and sinus conditions with a particular interest in sinonasal tumors and has been involved in endoscopic sinus surgery and its extended applications since the early 1980’s. She has contributed extensively to the literature. She has received several prizes including the George Davey Howell (1990, 2008, 2015), W J Harrison (Royal Society of Medicine 2012), BMA Book awards and Jobson Horne Prize (2018) . In 2008 she was awarded a CBE for services to medicine by the Queen, is a member of the German Academy of Science (Leopoldina) and is an Honorary Fellow of the American College of Surgeons.
Affiliations and expertise
Professor of Rhinology, University College, London; Honorary Consultant ENT Surgeon, Royal National Throat, Nose and Ear Hospital Trust, University College and Moorfields Eye Hospitals, London, UKKR
K. Thomas Robbins
In 2004, K. Thomas Robbins was appointed the Director at the SimmonsCooper Cancer Institute at Southern Illinois University. Dr. Robbins has served as a co-editor of the Cummings Otolaryngology-Head & Neck Surgery, since the 4th edition. He has been the author or co-author of hundreds of proffered publications. He has served on several editorial boards, including the Archives of Otolaryngology-Head and Neck Surgery. He is a past president of the American Head and Neck Society and served on the Board of Governors of the American College of Surgeons. He has chaired the Committee for Head and Neck Surgery and Oncology of the American Academy of Otolaryngology-Head and Neck Surgery and the Otolaryngology Head and Neck Surgery Council of the American College of Surgeons. Dr. Robbins’ academic interests have focused on modifications for conservation neck dissection and neck dissection nomenclature and he has received research funding from the National Cancer Institute.
Affiliations and expertise
Executive Director, SimmonsCooper Cancer Institute at SIU; Professor, Division of Otolaryngology Head & Neck Surgery, Southern Illinois University School of Medicine, Springfield, ILJT
J. Regan Thomas
Affiliations and expertise
Francis L. Lederer Professor, Department Head, Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago Medical Center, Chicago, ILML
Marci M. Lesperance
Dr. Marci Lesperance is the associate chief clinical officer for Children’s Specialty and Women’s Services, University of Michigan Medical Group. She served as the division chief of Pediatric Otolaryngology at Michigan Medicine for 15 years. Her research has been funded by NIH and outside foundations. She has previously served as surgeon in chief for the Children’s and Women’s Hospital, program director for the University of Michigan’s Pediatric Otolaryngology Fellowship, and past president of the American Society of Pediatric Otolaryngology. Dr. Lesperance is a member of numerous professional organizations in otolaryngology and pediatrics. Her research interests include hereditary hearing loss, molecular genetics of hearing loss, and genetic testing. She is also editor of the Elsevier text, Cummings Pediatric Otolaryngology, which is a spin-off from the main Cummings Otolaryngology text.
Affiliations and expertise
Professor, Department of Otolaryngology-Head and Neck Surgery, Associate Chief Clinical Officer, Children’s Specialty and Women’s ServicesHF
Howard W. Francis
Dr. Howard Francis is the Richard Hall Chaney, Sr. Distinguished Professor of Otolaryngology, Professor of Head and Neck Surgery and Communication Sciences, and Chair of Head and Neck Surgery and Communication Sciences at Duke University School of Medicine. His clinical work focuses on the diagnosis and treatment of ear diseases and skull base disorders. Dr. Francis takes great pride in the mastery of his craft and the high standard of his teams. As an ENT doctor, otologist, and neurotologist, he serves patients of all ages from infancy to the senior years, and his expertise spans the full range of the medical and surgical management of complex ear diseases, balance disorders, and hearing disorders - including performing cochlear implant surgery in adults and children.
Affiliations and expertise
Richard Hall Chaney, Sr. Distinguished Professor of Otolaryngology, Chair, Department of Head and Neck Surgery & Communication Sciences, Duke University Health System